The aetiology and maintenance of social anxiety disorder: A synthesis of complimentary theoretical models and formulation of a new integrated model

- Aetiological models and maintenance models for social anxiety disorder (SAD) exist.
- We review the aetiological models and maintenance models of SAD.
- We propose a new integrated aetiological and maintenance (IAM) model of SAD.
- We review the empirical literature with respect to the IAM model.
- The IAM model can guide future research into the development and persistence of SAD.

BackgroundWithin maintenance models of social anxiety disorder (SAD), a number of cognitive and behavioural factors that drive the persistence of SAD have been proposed. However, these maintenance models do not address how SAD develops, or the origins of the proposed maintaining factors. There are also models of the development of SAD that have been proposed independently from maintenance models. These models highlight multiple factors that contribute risk to the onset of SAD, but do not address how these aetiological factors may lead to the development of the maintaining factors associated with SAD.MethodsA systematic review of the literature was conducted to identify aetiological and maintenance models of SAD. We then united key factors identified in these models and formulated an integrated aetiological and maintenance (IAM) model of SAD. A systematic review of the literature was then conducted on the components of the IAM model.ResultsA number of aetiological and maintaining factors were identified in models of SAD. These factors could be drawn together into the IAM model. On balance, there is empirical evidence for the association of each of the factors in the IAM model with social anxiety or SAD, providing preliminary support for the model.LimitationsThere are relationships between components of the IAM model that require empirical attention. Future research will need to continue to test the IAM model.ConclusionsThe IAM model provides a framework for future investigations into the development and persistence of SAD.